Between 2004 and 2014, the doctor allegedly billed Medicare, Medicaid and private insurers for face-to-face visits with patients that never actually occurred. He admitted to altering patients’ medical charts by inserting fabricated vital signs and clinical notes to make it appear as if they had actually seen him on the billed dates. The doctor racked up over $280,000 in services he did not provide.
During this time, at least four of his employees informed him that his billing scheme was unlawful. In October of 2013, the doctor was recorded in a conversation with an employee explaining that the fact that he wrote something down on their charts was sufficient to entitle him to payment. Once an insurance carrier began auditing the defendant, he purportedly shredded the original medical records.
According to Acting Attorney General, the doctor’s behavior was particularly reprehensible because he stole from Medicaid, a program designed to assist people who cannot afford health insurance or health care services.
After an investigation by the FBI and Inspector General’s Office for the U.S. Department of Health and Human Services, the physician was arrested by the FBI in 2015 and pled guilty to one count of health care fraud. He was subsequently sentenced to 37 months in federal prison and ordered to pay restitution to more than 12 private insurance companies and the federal government. Upon his release, he will be supervised for three years. He is prohibited from reapplying for his medical license.
Philadelphia Health Care Lawyers at Sidney L. Gold & Associates Represent Physicians Facing Possible Loss of Medical License
When your reputation and good name are at stake, you need the services of a highly experienced team of lawyers standing behind you. If you are facing licensing issues of any type, the experienced Philadelphia health care lawyers at Sidney L. Gold & Associates are prepared to help. To schedule a consultation, call us at 215-569-1999 or complete our online contact form. With offices conveniently located in Philadelphia, we serve clients throughout Pennsylvania, New Jersey and New York.